l*******G
发帖数: 1191 | |
A*******s
发帖数: 9638 | 2 Behcet's disease?
There is a case report that facial swelling may be explained by superior
vena cava syndrome as a complication in Behcet's.
Yuzaiusa, your opinion?
【在 l*******G 的大作中提到】
: http://www.mitbbs.com/news_wenzhang/Headline/31546941.html
: 这个真奇怪
|
y******a
发帖数: 590 | 3 Behcet's不象。不知道核磁共振具体看到了什么，从哪里取的淋巴结活检。国内的医生
没有明确的病理诊断就敢给各种治疗方案，咳咳 |
A*******s
发帖数: 9638 | 4 这个病人从有限的病史看是一个结缔组织病， 面部软组织炎症， 口腔粘膜溃疡， MRI
顶多能看到edema。 淋巴结可以是nonspecific， 我同意他们至少要做一个皮下组织活
检。
面部水肿除了炎症就是venous thrombosis了，所以我想到了白塞氏病： 皮肤，粘膜，
还是年轻女性， 。。。 其他部位， eye和genital的情况不知道。
当然这个case肯定不典型， 所以只能求助于rheumatologist了。 国内的医生确实胆大
， 没有诊断就上药，现在的临床表现就更复杂了。
【在 y******a 的大作中提到】
: Behcet's不象。不知道核磁共振具体看到了什么，从哪里取的淋巴结活检。国内的医生
: 没有明确的病理诊断就敢给各种治疗方案，咳咳
|
w*********i
发帖数: 46 | 5 It is Kimura's disease. I made such a diagnosis a couple months ago. It is
relatively common in Asian population; however, my patient is a white guy.
It is relatively rare. I have seen two cases in past ten years. |
l*******G
发帖数: 1191 | 6 what is the cure for either buhcet or Kimura? Thanks! |
w*********i
发帖数: 46 | 7 I am not sure. It is actually a proliferation of epithelioid blood vessels
along with lymphoid tissue and numerous eosinophils. Its another name is
angiolymphoid hyperplasia with eosinophilia. It sometimes presents as a
nodule and you can excised it; however it may also present as a mass just
like for this patient. I guess surgery with radiation may help. I am not
sure if steroid is able to treat the disease since there are lots epitheioid
blood vessels within the lesion. |
l*******G
发帖数: 1191 | |
l*******G
发帖数: 1191 | 9 也有人说是Hereditary Angioedema (HAE)？ |
w*********i
发帖数: 46 | 10 It is too late and too big. If the disease was diagnosed earlier, it might
not be so difficult to treat. Unfortunately, most physicians, including a
lot of US physicians don't know how to make this diagnosis. When I made
that diagnosis, most of my colleagues had no idea what I was talking about
until they matched my slides with pictures in the text books. |
|
|
w*********i
发帖数: 46 | 11 It is Kimura's disease. No doubt.
【在 l*******G 的大作中提到】
: 也有人说是Hereditary Angioedema (HAE)？
|
l*******G
发帖数: 1191 | 12 也有人说是Hereditary Angioedema (HAE)？
狗日的腾讯，我刚才把上面几位的看法贴到了腾讯新闻上，没3分钟就被删除了。
http://news.qq.com/a/20120827/000497.htm |
A*******s
发帖数: 9638 | 13 Yep, looks like what you said.
It is just another example of " Chances favor the prepared mind", lol
Do you make the diagnosis on subdermal tissue or lymph node biopsy?
Regarding the treatment, it is said benign, so is it self-limited?
http://en.wikipedia.org/wiki/Kimura_disease#Pathophysiology
is
.
【在 w*********i 的大作中提到】
: It is Kimura's disease. I made such a diagnosis a couple months ago. It is
: relatively common in Asian population; however, my patient is a white guy.
: It is relatively rare. I have seen two cases in past ten years.
|
S******9
发帖数: 2837 | 14 Kimura's disease中文就是“木村病”，又叫：嗜酸性粒细胞增生性淋巴肉芽肿，血
管淋巴样增生伴嗜酸性粒细胞增多 |
A*******s
发帖数: 9638 | 15 Kimura's disease看来是靠病理确诊的， 这个病人的淋巴结活检是阴性， 所以诊断不
应该是final。
【在 S******9 的大作中提到】
: Kimura's disease中文就是“木村病”，又叫：嗜酸性粒细胞增生性淋巴肉芽肿，血
: 管淋巴样增生伴嗜酸性粒细胞增多
|
y******a
发帖数: 590 | 16 老大，你还真爱给人看病，记者写的东西也能叫病史，那咱们都下岗得了。没有病史，
没有查体，没有影像，没有tissue，怎么给诊断啊。楼上那个大哥还说kimura，汗啊。
。。不好意思，得罪了
MRI
【在 A*******s 的大作中提到】
: 这个病人从有限的病史看是一个结缔组织病， 面部软组织炎症， 口腔粘膜溃疡， MRI
: 顶多能看到edema。 淋巴结可以是nonspecific， 我同意他们至少要做一个皮下组织活
: 检。
: 面部水肿除了炎症就是venous thrombosis了，所以我想到了白塞氏病： 皮肤，粘膜，
: 还是年轻女性， 。。。 其他部位， eye和genital的情况不知道。
: 当然这个case肯定不典型， 所以只能求助于rheumatologist了。 国内的医生确实胆大
: ， 没有诊断就上药，现在的临床表现就更复杂了。
|
A*******s
发帖数: 9638 | 17 不是给人看病， 而是brainstorm，或者说entertain一下。 这个病确实挺有意思， 不
过我觉得顶多叫syndrome， 不能称之为病。 有可能就是lupus/behcet之类病的变异而
已， 居然让日本人把它命名了，中国的中医名医呢？
【在 y******a 的大作中提到】
: 老大，你还真爱给人看病，记者写的东西也能叫病史，那咱们都下岗得了。没有病史，
: 没有查体，没有影像，没有tissue，怎么给诊断啊。楼上那个大哥还说kimura，汗啊。
: 。。不好意思，得罪了
:
: MRI
|
w*********i
发帖数: 46 | 18 Some diseases need clinical history or tissue to make a diagnosis. Some
diseases, such as Kimura's disease, don't need these. Once you see it, you
will know it. If you don't believe, please open any dermatology books for
this disease. You will find out that this patient's appearance is so typical
for that disease. But if you are not familiar with this disease, you will
probably never make this diagnosis. That's the reason they pay big bucks
for us. Please forgive me if I offend someone. |
y******a
发帖数: 590 | 19 你还别说，小日本颇命名了一些病，什么kawasaki，kikuchi之类的
【在 A*******s 的大作中提到】
: 不是给人看病， 而是brainstorm，或者说entertain一下。 这个病确实挺有意思， 不
: 过我觉得顶多叫syndrome， 不能称之为病。 有可能就是lupus/behcet之类病的变异而
: 已， 居然让日本人把它命名了，中国的中医名医呢？
|
A*******s
发帖数: 9638 | 20 我对日本医学没有研究， 但可以想象他们的医学应该是西方科学化的， 他们研究中医
也就是兴趣而已。
【在 y******a 的大作中提到】
: 你还别说，小日本颇命名了一些病，什么kawasaki，kikuchi之类的
|
A*******s
发帖数: 9638 | 21 How do you explain the LN biopsy result in this case? I know some
dematological diseases can be diagnosed based on their look, but even for a
drug rash, like steven johnson syndrome, I still see dematologists do a
biopsy prior to making a formal diagnosis.
A tissue diagnosis is important in this case. Same symptoms can be seen in
different diseases.
you
typical
【在 w*********i 的大作中提到】
: Some diseases need clinical history or tissue to make a diagnosis. Some
: diseases, such as Kimura's disease, don't need these. Once you see it, you
: will know it. If you don't believe, please open any dermatology books for
: this disease. You will find out that this patient's appearance is so typical
: for that disease. But if you are not familiar with this disease, you will
: probably never make this diagnosis. That's the reason they pay big bucks
: for us. Please forgive me if I offend someone.
|
S**********e
发帖数: 1325 | 22 真长知识。唉！如果这个木村脸能够像木村拓哉，就比较便于记忆了。 |
